Healthcare Provider Details

I. General information

NPI: 1306766456
Provider Name (Legal Business Name): NOAH TAYLOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 S 910 W UNIT 73
PLEASANT GROVE UT
84062-2486
US

IV. Provider business mailing address

587 S 910 W UNIT 73
PLEASANT GROVE UT
84062-2486
US

V. Phone/Fax

Practice location:
  • Phone: 801-382-8999
  • Fax:
Mailing address:
  • Phone: 801-382-8999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14298203-3503
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: